Optum Health’s turnaround picks up speed

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Optum Health’s earnings from operations climbed to $735 million in the third quarter, up from $41 million a year earlier, as UnitedHealth Group’s care delivery arm continues to recover from a challenging 2025.

The unit’s operating margin rose to 3.2% from 0.2%, according to UnitedHealth’s Oct. 13 earnings release. On an adjusted basis, the margin was 2.6%.

The gains came on a smaller business. Optum Health’s revenue fell 10% year over year to $22.9 billion, and the number of consumers it served slipped to 92 million from 93 million. UnitedHealth attributed the revenue decline to fewer value-based care patients served in markets “where Optum lacked sufficient value-based care presence to sustain its clinicians.”

Speaking on UnitedHealth Group’s Oct. 13 earnings call, Optum CEO Patrick Conway said the results were “driven by the continued return to value-based care principles, combined with strong execution across our clinical programs and operational improvements.”

He pointed to a few early markers during the call: 

  • Online self-scheduling is up 27% from last year.
  • Home health visits are up 10%.
  • Patient referrals to behavioral health specialists placed in Optum’s primary care practices have doubled since last year, with an engagement rate above 90%.

Optum Health CEO Krista Nelson said the unit’s clinical programs, including efforts to reduce unnecessary inpatient stays and expand access to primary, preventive and home care, are “going to continue to be durable as we head into 2027.”

The fourth quarter of 2026 will look softer, however. One analyst on the call noted that UnitedHealth’s guidance appears to imply a meaningfully negative fourth quarter for Optum Health. Ms. Nelson attributed that to normal risk seasonality and investments in clinician workflows, including AI-enabled care summaries, ambient documentation and scheduling tools. Executives did not say how much they plan to spend.

Ms. Nelson said she sees room for growth in three areas: 

  • More value-based arrangements, including professional capitation and shared savings
  • High-performing service lines such as home health, hospice and surgery centers
  • New products, including one built with a payer partner to manage risk across post-acute care, from the inpatient stay through skilled nursing and home health

The company is targeting operating margins of 6% to 8% for Optum Health by 2028. Ms. Nelson called it “a multiyear journey” but said 2027 will show “a strong pace” toward that range.

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